Kasperbauer Shannon H, Daley Charles L
Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, Colorado 80206, USA.
Semin Respir Crit Care Med. 2008 Oct;29(5):569-76. doi: 10.1055/s-0028-1085708. Epub 2008 Sep 22.
MYCOBACTERIUM AVIUM complex (MAC) consists of nontuberculous mycobacteria that cause disease in immunocompromised and immunocompetent hosts. The organisms are ubiquitous in the environment, and acquisition occurs through ingestion or inhalation of aerosols from soil, water, or biofilms. Disease may manifest as disseminated infection, soft tissue infection, chronic pneumonia, or hypersensitivity pneumonitis. Nontuberculous mycobacteria are increasingly associated with pulmonary disease, with MAC being the most common nontuberculous mycobacteria to cause pulmonary disease in the United States. Pulmonary symptoms, nodular or cavitary opacities on a chest radiograph or high-resolution computed tomographic scan with multifocal bronchiectasis and multiple small nodules, plus positive culture results from two sputum specimens or one bronchoscopic specimen are consistent with MAC pulmonary disease. Treatment consists of a macrolide, rifamycin, and ethambutol given three times weekly for noncavitary disease and daily with or without an aminoglycoside for cavitary disease.
鸟分枝杆菌复合群（MAC）由非结核分枝杆菌组成，可在免疫功能低下和免疫功能正常的宿主中引起疾病。这些微生物在环境中普遍存在，通过摄入或吸入来自土壤、水或生物膜的气溶胶而感染。疾病可能表现为播散性感染、软组织感染、慢性肺炎或过敏性肺炎。非结核分枝杆菌与肺部疾病的关联日益增加，MAC是美国导致肺部疾病最常见的非结核分枝杆菌。肺部症状、胸部X线片或高分辨率计算机断层扫描上的结节状或空洞性混浊，伴有多灶性支气管扩张和多个小结节，加上两份痰标本或一份支气管镜标本的培养结果呈阳性，符合MAC肺部疾病。治疗包括大环内酯类、利福霉素和乙胺丁醇，非空洞性疾病每周给药三次，空洞性疾病每日给药，可加用或不加用氨基糖苷类药物。
